situations arise. The journal helps to make them aware of their thoughts and shows how such thoughts affect behavior. Modeling During modeling, the healthcare professional and patients participate in role-playing exercises. The purpose of Conditioning Conditioning encompasses the use of reinforcement to encourage a particular behavior. For example, a youth with attention-deficit/hyperactivity disorder gets additional time to spend on the computer every time they stay focused on tasks and accomplish certain daily chores. The computer Systematic Desensitization Because many adolescents with substance use disorders also present with anxiety problems, desensitization is a useful strategy. Adolescents imagine a situation they fear, while healthcare professionals employ techniques to help them relax, teaching coping skills that will eventually Case Study: Stephanie Grove Stephanie Grove is an 18-year-old college freshman. She comes from a small town and has moved to a large metropolitan area to attend a prestigious university. Stephanie has always been rather shy and without much confidence, so this move is a huge step for her. Stephanie is eager to excel academically, but she would also like to be a social success. Having made few friends during her high school years, she now wants to “finally have some fun!” Her roommate, Beverly, is a self-confident young woman who is eager to help Stephanie enjoy an active social life. Beverly invites Stephanie to come with her to a party being held off campus. When they arrive, they become part of the boisterous crowd of partygoers. Alcoholic beverages are flowing in abundance, and the scent of marijuana permeates the air. Stephanie meets a fellow freshman, Mark, who shows an interest in getting to know her. He says that he was once shy as well, but a few drinks “help me to be the life of the party!” Although Stephanie does not drink and has never done drugs, she accepts the bottle of beer that Mark offers her. After a few drinks, Stephanie relaxes, begins to enjoy herself, and is looking forward to more party time. Over time, Stephanie begins to depend on alcohol to help her cope with the stress of being away from home for the first time and dealing with the challenges of a demanding academic schedule. She and Mark are taking many of the same classes and frequently go out on dates. Stephanie feels that she is finally “growing up” and anticipates a happy and successful college life. However, alcohol is becoming increasingly necessary for her to cope with the stressors in her life. Her new friends also rely on alcohol and tell Stephanie that “a few drinks every day or two won’t kill you.” Stephanie wants to make sure that she “fits in” with Mark and her new friends, and alcohol use seems to be a necessary part of these friendships. As her alcohol intake increases, she finds it increasingly difficult to succeed in her classes. She is in danger of failing one course, and her grades are below average in the others. She is sleeping later and later after nights out partying, which results in her skipping many of her classes. After an evening of excessive drinking, Stephanie collapses and her friends have trouble arousing her. They take her to the campus emergency health service office and make a swift departure, leaving Stephanie to deal with the aftermath of her alcohol intake alone. Stephanie is referred to a university therapist who specializes in SUD. She is reluctant to admit that she has a problem,
In later stages of treatment, it may serve to demonstrate and reinforce positive behaviors.
modeling is to identify alternative behaviors or responses to difficult situations via role-play (Kendall & Peterman, 2015).
time reinforces and increases the desired behavior by identifying it with something positive. Reinforcement can also be used to extinguish unwanted behaviors by imposing negative consequences (Current Nursing, 2020).
eliminate the anxiety altogether. The adolescent gradually becomes desensitized to the old fear response and learns how to react while staying relaxed (Brennan, 2021; Current Nursing, 2020).
saying that she will “figure it out.” However, Stephanie is secretly frightened about her alcohol use and decides that “it can’t hurt” to see the counselor regularly. During therapy sessions, Stephanie admits that her alcohol use might be a problem but that she can cut down if she really tries. Stephanie is reluctant to completely give up alcohol because it has become such an important part of her social life. She says she prefers to do things on her own and doesn’t like other people involved in her problem-solving efforts. “I like thinking things out on my own. I can talk to you if we are alone. I’m not into any of these group things or play acting .” Question Stephanie and her counselor discuss various treatment strategies as they tentatively begin to establish a therapeutic relationship. What treatment options seem to be the best choices for Stephanie? Are there any treatment strategies that would not be good choices for Stephanie? Discussion Abstinence versus harm reduction is the initial starting point for identifying treatment strategies for Stephanie. Although abstinence is the most traditional SUD treatment form, Stephanie has been fairly determined about wanting to cut back, but not stop using alcohol. She may benefit from a harm reduction approach that focuses on decreasing risk of injury and fatalities as well as the impact on her academic and social life. As Stephanie and her counselor continue to establish a trusting professional relationship, she may eventually be able to face and deal with her alcohol use. Eventually, she may move into an abstinence approach, depending on the direction her therapy takes. Stephanie may benefit from motivational interviewing. Motivational interviewing involves the establishment of an individualized therapeutic rapport that helps people to openly discuss what they are feeling and thinking in a supportive environment. Since Stephanie is not comfortable in a group, she may welcome the establishment of motivational interviewing to allow her free, uninhibited discussion. Cognitive-behavioral therapy focuses on helping Stephanie to recognize when and where she is most likely to drink alcohol, how to avoid these types of situations, and how to deal with the impact of alcohol use. If Stephanie follows the harm reduction method, cognitive-behavioral therapy will help her to reduce her alcohol intake and the negative impacts of its use.
Page 103
Book Code: SWUS1525
EliteLearning.com/Social-Work
Powered by FlippingBook